Provider Demographics
NPI:1023299591
Name:PM&R COUNSELING
Entity type:Organization
Organization Name:PM&R COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:CORYDON
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-581-5741
Mailing Address - Street 1:UNIVERSITY MEDICAL CENTER PMR
Mailing Address - Street 2:30 NO. 1900 EAST
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-2119
Mailing Address - Country:US
Mailing Address - Phone:801-581-5741
Mailing Address - Fax:801-585-5757
Practice Address - Street 1:UNIVERSITY MEDICAL CENTER PMR
Practice Address - Street 2:30 NO. 1900 EAST
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2119
Practice Address - Country:US
Practice Address - Phone:801-581-5741
Practice Address - Fax:801-585-5757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF UTAH HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT283X00000X, 273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No283X00000XHospitalsRehabilitation Hospital